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Getting Treatment Coverage

ADAP is an AIDS Drug Assistance Program. Some states call these programs, which are paid for by federal and state funds, other names but still offer a list or formulary of drugs, as well as some blood tests or even small devices for measuring blood sugar or injecting drugs. Usually you just call the ADAP phone number and say you want to apply.

Some states require a Case Manager, others don't. Each state has different requirements and offers different types of programs. You usually have to apply for Medicaid first, although some ADAPs help people with private insurance, Medicare Part D or no insurance. If you have questions you can e-mail us

There are many categories of drugs related to treating HIV or Hepatitis co-infection. Sometimes, a state will have a separate Hepatitis vaccination or testing program. You might also need to look for other programs to meet your needs. Don't drop your insurance coverage or COBRA premiums without first seeing if your state will cover part or the whole premium or drug cost co-pays. Apply to get Medicaid or Medicare or private insurance with the help of your case manager.

You might also need to try a Patient Assistance Program. The pharmaceutical industry has set up programs that offer medications for free, or sometimes at a very low price. You may have to apply directly to a specific company. Your doctor or another member of your health care team like a Case Manager will usually help you out to apply, and you may need to apply to more than one company for the treatments you need.

Other times, the best way to find out about Hepatitis treatments is to contact an agency or organization that deals mostly with AIDS, or the HIV/STD Department of your state.You might also consider experimental drugs.

HIV Treatments

• Ziagen - abacavir
• Epzicom - lamivudine/abacavir
• Trizivir - abacavir/lamivudine/zidovudine
• Videx - didanosine
• Emtriva - emtricitabine
• Truvada - emtricitabine/tenofovir
• Epivir - lamivudine
• Combivir - lamivudine/zidovudine
• Zerit - stavudine
• Viread - tenofovir
• Retrovir - zidovudine

Non-nucleosides (Non-Nukes or NNRTIs)

• Intelence - etravirine
• Sustiva - efavirenz
• Viramune - nevirapine
• Rescriptor - delavirdine

• Reyataz - atazanavir
• Prezista - darunavir (new 600mg)
• Lexiva - fosamprenavir
• Crixivan - indinavir
• Kaletra - lopinavir/ritonavir
• Viracept - nelfinavir
• Norvir - ritonavir
• Invirase - saquinavir mesylate
• Aptivus* - tipranavir

• Atripla - efavirenz, tenofovir and emtricitabine

• Fuzeon* - enfuvirtide
• Selzentry* - maraviroc

• Isentress - raltegravir

Hepatitis Vaccinations and Treatments

• Pegasys - peginterferon alfa-2a
• PEG Intron - peginterferon alfa-2b
• Ribavirin (Rebetol, Copegus, Ribasphere)

• Baraclude - entecavir
• Hepsera - adefovir dipivoxil

Other Covered Treatments

Scroll down through the box or download the ADAP and ADAP Plus services version in PDF.

Herpes Infections - acyclovir, penciclovir, valacyclovir

Mycobacterial Infections - amikacin, capreomycin, ciprofloxacin, clarithromycin, cycloserine, ethambutol, ethionamide, gatifloxacin, isoniazid, kanamycin, moxifloxacin, ofloxacin, aminosalicyclic acid, pyrazinamide, rifabutin, rifampin w/wo combinations, rifapentine, streptomycin

CMV disease - formivirsen, foscarnet, ganciclovir, cidofovir, probenecid, valganciclovir

Fungal infections - amphotericin B, caspofungin, clotrimazole, econazole, fluconazole, flucytosine, griseofulvin, itraconazole, ketoconazole, miconazole, nystatin, terbinafine, terconazole, voriconazole

Toxoplasmosis - azithromycin, clindamycin, leucovorin, pyrimethamine, sulfadiazine, triple sulfa

Cryptosporidiosis - paromomycin

Microsporidiosis - albendazole

Parasitic Infection - ivermectin

PCP Prophylaxis and Treatment - atovaquone, clindamycin, dapsone, hydroxyzine, leucovorin, pentamidine, primaquine, sulfadoxine/pyrimethamine, trimethoprim, sulfamethoxazole- trimethoprim, atovaquone (Mepron) requires prior authorization, please call 1-800-832-5305.

Antineoplastics - alitretinoin, bleomycin, cyclophosphamide, cytarabine, dexamethasone, doxorubicin, etoposide, hydroxurea, interferon alfa, doxorubicin, daunorubicin liposomal, lomustine, methotrexate, paclitaxel, prednisone, procarbazine, vinblastine, vincristine

Wasting Syndrome - cyproheptadine, dronabinol, testosterone, megestrol, thalidomide, nandrolone

Prevention of bacterial infections in children ONLY (18 and under) - intravenous immune globulin

Condyloma - alpha N3, imiquimod, podofilox

Reiter's syndrome - sulfasalazine

Prevention of dental cavities - fluoride

Thrombosis - enoxaparin, warfarin

Vaccines - HPV vaccine, meningococcal vaccine

Antibiotics - amoxicillin, amoxicillin-clavulanate, ampicillin, aztreonam, bacitracin, cefaclor, cefadroxil, cefazolin, cefixime, cefoxitin, cefpodoxime, cefprozil, ceftazidime, ceftriaxone, cefuroxime, cephalexin, cephradine, chloramphenicol, chlorhexidine, cloxacillin, dicloxacillin, doxycycline, erythromycin, fosfomycin, furazolidone, gentamicin, imipenem - cilastatin, levofloxacin, loracarbef, metronidazole, minocycline, mupirocin, nitrofurantoin, penicillin, sparfloxacin, spectinomycin, tetracycline, tobramycin, ticarcillin-clavulanate, vancomycin

Other related drugs - chlorhexidine gluconate, probenecid

Analgesics - butalbital combination w/wo/ codeine, codeine w/wo/ ASA, APAP, diclofenac, diethylpropion, diflunisal, fenoprofen, fentanyl (patch only), flurbiprofen, hydrocodone w/ ASA, APAP, hydromorphone, ibuprofen, indomethacin, ketoprofen, ketorolac, levorphanol, lidocaine, methadone*, morphine, naproxen, oxycodone w/wo/ ASA, APAP, piroxicam, sulindac, tolmetin, tramadol *Methadone is available only for pain relief; ADAP does not cover methadone maintenance

Anti-Diarrheals/Malabsorption - atropine-diphenoxylate, loperamide, pancrelipase, opium

Psychotropics - alprazolam, amitriptyline, aripiprazole, benztropine, bupropion, buspirone, butabarbital, chloral hydrate, chlordiazepoxide w/wo clidinium, chlorpromazine, citalopram, clomipramine, clonazepam, clorazepate, clozapine, desipramine, dextroamphetamine, diazepam, doxepin, duloxetine, escitalopram, fluoxetine, fluphenazine, flurazepam, fluvoxamine, halazepam, haloperidol, imipramine, lithium, lorazepam, loxapine, mesoridazine, methylphenidate, mirtazapine, molindone, nefazodone, nortriptyline, olanzapine, oxazepam, paroxetine, pemoline, pentobarbital, perphenazine, prochlorperazine, quetiapine, risperidone, secobarbital, sertraline, temazepam, thioridazine, thiothixene, trazodone, triazolam, trifluoperazine, trimipramine, venlafaxine, ziprasidone, zolpidem

Anticonvulsants - carbamazepine, divalproex sodium, felbamate, gabapentin, lamotrigine, levetiracetam, magnesium sulfate, oxcarbazepine, phenytoin, pregabalin, primidone, tiagabine, topiramate, valproic acid

Cardiac Medications - Cardiac medications listed individually are available in combination with other listed cardiac medications: acebutolol, amiloride, amlodipine, atenolol, benazepril, bendroflumethiazide, betaxolol, bisoprolol, bumetanide, candesartan, captopril, carteolol, carvedilol, chlorothiazide, chlorthalidone, clonidine, clopidogrel, digoxin, diltiazem, doxazosin, enalapril, felodipine, fosinopril, furosemide, guanabenz, guanadrel, guanfacine, hydralazine, hydrochlorothiazide, hydroflumethiazide, indapamide, irbesartan, isosorbide, isoxsuprine, isradipine, labetalol, lisinopril, losartan, methyclothiazide, methyldopa, metolazone, metoprolol, minoxidil, moexipril, moricizine, nadolol, nicardipine, nifedipine, nisoldipine, nitroglycerin, papaverine, penbutolol, pindolol, polythiazide, prazosin, procainamide, propranolol, quinapril, ramipril, sotalol, spironolactone, telmisartan, terazosin, tocainide, torsemide, trandolapril, triamterene, trichlormethiazide, valsartan, verapamil

Hyperlipidemia - atorvastatin, cholestyramine, colestipol, ezetimibe, fenofibrate, fluvastatin, gemfibrozil, niacin, omega 3 fatty acids (Rx only), pravastatin, rosuvastatin

Gastrointenstinal Medications - amylase-lipase-protease, cimetidine, dolasetron, esomeprazole, granisetron, lansoprazole, metoclopramide, misoprostol, omeprazole, ondansetron, pantoprazole, rabeprazole, ranitidine, sucralfate, thiethylperazine, trimethobenzamide

Insulin - acarbose, acetohexamide, chlorpropamide, glimepiride, glipizide, glyburide, insulin, metformin, miglitol, pioglitazone, repaglinide, rosiglitazone, tolazamide, tolbutamide

Sinusitis Medications - acrivastine/pseudoephedrine, azatadine, brompheniramine w/wo combinations, budesonide, carbinoxamine, chlorpheniramine w/wo/ combinations, clemastine, dexbrompheniramine/pseudoephedrine, dexchlorpheniramine, diphenhydramine, fexofenadine, mometasone, naphazoline w/wo combinations, phenir/ppa/phenylt./ pyrilamine, phenylephrine-promethazine, phenylprop-pyril-pheniramine, phenyltolox-APAP, phenyltolox/ pyril/pheniramine, promethazine, triprolidine

Topical Steroids - alclometasone, amcinonide, amlexanox, betamethasone, clobetasol, clocortolone, desonide, desoximetasone, diflorasone, fluocinolone, fluorometholone, fluticasone, flurandrenolide, halcinonide, halobetasol, hydrocortisone w/wo/ combinations, neomycin w/wo/ combinations, prednicarbate, prednisolone, triamcinolone

Bronchodilator/Respiratory Inhalants - funisolide, salmeterol, albuterol, albuterol-ipratropium, terbutaline, beclomethasone, ipratropium, theophylline, bitolterol, metaproterenol, triamcinolone, budesonide, montelukast, zafirlukast, cromolyn, nedocromil, zileuton, dyphylline, oxtriphylline, fluticasone, pirbuterol, tiotropium (Solutions for nebulizers are not covered)

Urinary Incontinence - flavoxate, oxybutynin, tolterodine

Gynecological - estrogen, progestins, estrogens-progestins

Ophthalmological - acetylcholine, apraclonidine, atropine, brimonidine, brinzolamide, carbachol, cyclopentolate, cyclopentolate-phenylephrine, dipivefrin, dorzolamide, dorzolamide-timolol, ecothiopate, homatropine, latanoprost, levobunolol, loteprednol, medrysone, metipranol, pilocarpine, prednisolone, rimexolone, timolol, tropicamide w/wo hydroxyamphetamine

Partial Opioid Agonist - buprenorphine

Nicotine Cessation (Rx only) - nicotine nasal spray, nicotine inhaler, varenicline

Ancillary Devices - glucose monitor (limit one), glucose test control solution, glucose test strips, lancets/lancet devices, peak flow meter, spacers/aerochambers syringes/needles (reimbursable only with a prescription for an injectable drug covered by ADAP)

Drugs Requiring Prior Authorization

Request Form and Guidelines available (1-800-542-2437).

Antiretroviral Therapy - enfurvirtide (Fuzeon, T-20). Call 1-800-832-5305 to initiate the prior authorization process.
tipranavir (Aptivus). Call 1-800-832-5305 to initiate the prior authorization process.

PCP and Toxoplasmosis Indications - atovaquone (Mepron) - for the treatment or prophylaxis of PCP or toxoplasmosis when first line treatments fail. Call 1-800-832-5305 to initiate the authorization process.

Hematological Indications - epoetin alfa for AIDS related anemia, with: Hct<30% and/or Hgb<10g/dl; and serum erythropoietin levels<500mU/ml, Filgrastim for severe neutropenia due to: chemotherapy; or drug toxicity or HIV disease with ANC<500/mm3, Sargramostim for severe neutropenia due to: chemotherapy;or drug toxicity or HIV disease with ANC<500/mm3, Immune globulin Rho (Win Rho SDF) for HIV-associated thrombocytopenia; with platelets<20,000 mm3. Prior authorization is not required for children. Oprelvekin (Neumega) - for chemotherapy induced thrombocytopenia; with platelet count <20,000/ul. and/or documented risk factors or clinical indications.